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Special Operation Forces

COL Tom Deal

USSOCOM Command Surgeon

March 2011

SOCOM SURGEON

USSOCOM Overview

USSOCOM Mission

SOF Medical Operations

AGENDA

United States Special Operations Command

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• History

• Mission

• The SOF Team

• SOF Truths

• 5th Truth

• Medical Synchronization

• SOF Medical Initiatives

• Questions

4 Right Place, Right Time, Right Adversary

Desert One

“It was risky and we knew it, but it had a good chance of success

and America had the courage to try.” (Holloway Report). Eight

Airmen and Marines died, eight aircraft were lost and American

Hostages spent an additional 244 days in captivity.

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NUNN-COHEN AMENDMENT

Established the U.S. Special Operations Command (USSOCOM)

and the Office of the Assistant Secretary of Defense for Special

Operations and Low Intensity Conflict (ASD/SOLIC)

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U.S. AFRICA

COMMAND

UNIFIED COMMANDS

Service-Like Responsibilities

…WITH SERVICE-LIKE RESPONSIBILITIES

Develop SOF strategy, doctrine, TTPs

Organize, train & equip SOF

Program & budget for SOF

Develop/procure SOF peculiar:

Equipment

Material, supplies, and services

Ensure interoperability of equipment and personnel

Monitor the management of SOF personnel

Conduct internal audits

USSOCOM Mission

Provide fully capable Special

Operations Forces to defend

the United States and its

interests. Plan and

synchronize operations against

terrorist networks.

SOF Core Tasks

Counter-proliferation of WMD

Counterterrorism

Special Reconnaissance

Direct Action

Unconventional Warfare

Foreign Internal Defense

Civil Affairs Operations

Information Operations

Psychological Operations

Security Force Assistance

Counterinsurgency Operations

Activities Specified by the President or SECDEF

AVIATION - FIXED WING & ROTARY WING SPECIAL TACTICS

AIR FORCE SPECIAL OPERATIONS SCHOOL

JOINT STANDING DEVELOPMENT, TRAINING & EXERCISES

SEAL TEAMS SPECIAL BOAT TEAMS

SEAL DELIVERY VEHICLE TEAMS NAVAL SPECIAL

WARFARE CENTER

SPECIAL FORCES RANGERS AVIATION

PSYOP CIVIL AFFAIRS JFK SPECIAL

WARFARE CENTER

COUNTERTERRORISM FOREIGN MILITARY TRAINING FORCE

AIR FORCE

SPECIAL OPERATIONS

COMMAND

(AFSOC)

Hurlburt Field, FL

JOINT SPECIAL

OPERATIONS COMMAND

(JSOC)

Ft. Bragg, NC

NAVAL SPECIAL

WARFARE COMMAND

(NAVSPECWARCOM)

Coronado, CA

UNITED STATES ARMY

SPECIAL OPERATIONS

COMMAND

(USASOC)

Ft. Bragg, NC

MARINE CORPS FORCES

SPECIAL OPERATIONS

COMMAND

(MARSOC)

Camp Lejeune, NC

United States

Special Operations Command

(USSOCOM)

The SOF Team

SOF Truths

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Humans are more important than hardware

Quality is better than quantity

Special Operations Forces cannot be mass produced

Competent Special Operations Forces cannot be created

after emergencies occur

5th SOF Truth

Most Special Operations Require Non-SOF

Assistance (The Forgotten Truth)

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Immature Theater Doctrinal Planning

“In an immature theater, or when operational

considerations dictate, the medical planner must be

opportunistic….”

-Appendix N, JP 3-05.3

Austere environments; Immature theaters; extended LOCs

Quick Strike or Protracted missions

Missions may be sensitive & highly classified

Limited organic medical assets (beyond level 1 care)

Require strategic evacuation (Military & Contract); Entry Points

Viability of HN Hospitals

Forward surgical capability (right sized and responsive)

Lab, Pvnt Med, Vet, Dental and Blood support

Medical logistics challenges

LNO support at MTFs; RTD Policy Issues

SOF Medical Planning Considerations

The SOF Combat Medic

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Advanced Special Operations Combat Medic • Special Operations Medical Sergeant (18D)

• Special Operations IDC(HM 8491)

• Fleet Marine Force Recon IDC (HM 8403)

Civil Affairs Medic (CAMS) • 68WW4 or (38W)

• Additional 7 weeks

Special Operations Combat Medic • 26 weeks@ Joint Special Operations Training Center

• 7 months PJ Course at Kirtland AB (Air Force)

• Paramedic + certification

• Trauma heavy, with military medicine component

CA

PA

BIL

ITIE

S

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ARMY

SF - 18D (ADSOCM), 18 SERIES (TCCC), PHYSICIAN / PA

RANGERS – 68WW1 (SOCM), PHYSICIAN / PA, EMT-B

SOAR - PHYSICIAN, 68W1 (SOCM)

CIVIL AFFAIRS / PSYOPS – 68W1&W4 (SOCM)

528th SOSB(SO)(ABN) - PHYSICIAN, PA, 68W1 (SOCM)

NAVY

SEAL TEAM – MEDIC (SOCM/ADSOCM)

PHYSICIAN (GROUP LEVEL)

AIR FORCE

STS – PARARESCUEMEN (PJs) (SOCM)

SOFME – PHYSICIAN, PA, 4N0XX

MARINES

CORPSMAN (SOCM/ADSOCM)

PHYSICIANS

SOF Levels of Medical Support Role I

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SOF Aid Station, Afghanistan Trauma

Team

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Special Ops Surgical Team (SOST)

Personnel

General Surgeon

Orthopedic Surgeon

Emergency Physician

Anesthesiologist

Operating Room Technician

Capabilities

Resuscitative surgery & advanced trauma life

support for 20 casualties for up to 48 hours of

continuous operation

Equipment

Self-contained in man-portable field packs (500 lbs)

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Special Ops Critical Care Evacuation

Team (SOCCET)

Personnel

Intensive Care Physician

Critical Care Nurse

Cardiopulmonary Technician

Capabilities

Critical care/casualty management

of four stabilized (post-trauma/operative) aboard

SOF aircraft & other opportune evacuation

platforms for up to 36 hours of continuous

operation

Equipment

Self-contained in man-portable field packs (300 lbs)

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Special Operations Resuscitative Team

SORT(ABN)

Personnel

Physician or PA

Critical Care Nurse

LPN

SOCM x 2

Patient Admin Tech

Lab Tech

X-ray Tech

Capabilities

4 Critical / 6 non-critical care patient beds

24-hour sick call and emergency medical care

Blood, X-ray, ultrasound, lab & oxygen generation

Medical operations and patient administration

Preventive, primary and aerospace medicine

Routine and emergency dental care

Routine and emergency veterinary care

Medical logistics and biomedical maintenance

Level I care*

Damage control surgery*

Critical care transport*

*Capabilities not organic to SB(SO)(A)

VETERINARY

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Veterinary

Advise the Commander, components, and TSOCs on all veterinary

related issues to include medical training and operational animal

health care, zoonotic Force health Protection issues.

Command’s SME on Live Tissue Training Policy

Advisor and integral member of Committee on Canine Tactical

Combat Casualty Care

Provides technical and professional oversight for all special

operation veterinary personnel

Future of Live Tissue Training/Medical simulation

Participant on the USD Chartered Joint Analysis Team

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Human Performance (HP)

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Professional Sports Model MIL

Variant Capabilities

Trains – Organizes and Equips

Maintains and increases Operator Performance thresholds

(to what standard >20%)

Repair and Restore

Performs Pre-Habilitation and Re-Habilitates

Tests for Function and Capacity

Supports Physiology – identifies pathology – etiology

Applies emerging technologies

Enforces standards – reports declines and progressions

It can optimize, enhance and modify as required

NOT responsible for health and wellness

TBI…needs

Better ability to dx/quantify in the field

Improvements in immediate treatment

Treatment to prevent secondary (late) injury

Improvements in long term care for mod – severe.

One socom unit currently doing very thorough

intake/periodic/and exit Human Performance Data

collection to include broad neurocognitive base

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Damage Control Resuscitation (DCR)

DCR….resonates with SOF medical planning where

immediate MEDEVAC not possible

Improved methods for temporizing care for TBI

(?selective cerebral cooling, ?procoagulants)

Improved means of controlling non-compressible

hemorrhage (freeze dried plasma, Factor rVIIa or other

injectables)

Best antibiotic coverage / analgesia

Improvements in critical care in Theater

(Rotary Wing )

Personnel training

Further training for Flight Medics or recruit MOSs

already working in ICUs?

Faster airframes with increased distance and speed

Desired Airframe Capabilities

White light

Stand up & walk around the casualty capability

Improvements in PDES

Improvements in the process to provide more rapid

adjudication very desirable

Can better pre-deployment baselines and better post injury

imaging better quantify TBI disability

Can pre and post injury EEGs add to the science

Access to Information

USSOCOM has under Title 10 service-like

responsibility

Many data repositories are service specific, making

it difficult to separate out SOCOM data sets.

Pain Management

Army TSG’s Pain Management TF has provided training for

indwelling nerve blocks

We’re trying to promote better awareness of

‘polypharmacy’ issues…often difficult for BN surgeons to

have total visibility of use

Hoping that inhaled ketamine may improve battlefield care

? tools for assessment of performance while on any

medication (cognitive, judgmental, strength, endurance)

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Questions?

Questions?